Future perspectives in the treatment of pancreatic cancer
Progress in the treatment of advanced pancreatic cancer occurs at small incremental steps. Adjuvant chemotherapy has become a widely accepted standard of care in resectable pancreatic cancer and has a positive impact on survival. Treatment of locally advanced non-metastatic pancreatic cancer is more controversial. First results indicate that secondary chemo-radiotherapy (CRT) may be beneficial in patients who respond to initial chemotherapy. In metastatic pancreatic cancer chemotherapy with gemcitabine is a widely accepted standard of care. Among a multitude of combination therapies, only the combination of gemcitabine plus erlotinib has been registered for the treatment of pancreatic cancer. Further progress is expected from the exploration of new targeted agents, their integration into new concepts of chemotherapy, and the definition of predictive factors which may help to choose adequate treatment strategies for selected patient subgroups.